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MR. KEVIN WALLACE
NPI 1225388457
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since September 14, 2012
30 WARREN ST, BOSTON, MA 02135(617) 254-3800 Get Directions Write a Review

NPPES record last updated: September 14, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mr. Kevin Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEVIN WALLACE (NPI 1225388457) is an individual student in an organized health care education/training program in Boston, Massachusetts, licensed in Massachusetts (S50607188) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1225388457
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. KEVIN WALLACE
Location Address30 WARREN STBoston, MA 02135-3602
Mailing Address555 Washington StBrighton, MA 02135-2591
Phone(617) 254-3800
Sole ProprietorNo
Enumeration DateSeptember 14, 2012
✔ NPI 1225388457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MA · S50607188
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
30 WARREN ST, Boston, MA 02135
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE NILDA VISCARRA RN
Registered Nurse
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 254-3800
DR. ALISON MCVEY PT, DPT
Physical Therapist
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 254-3800
ALEX EDUARDO SANTOS LCSW
Social Worker (Clinical)
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 955-1564
ROSE MINICHIELLO
Music Therapist
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 254-3800
ABIGAIL LOUISE COOK FNP-C
Nurse Practitioner (Pediatrics)
30 WARREN ST
BOSTON, MA 02135
Suffolk County (617) 254-3800
ALICE FREEMAN GOODRICH LICSW
Social Worker (Clinical)
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 779-1685
ASIYA BAKSH MS
Occupational Therapist
30 WARREN ST
BOSTON, MA 02135
Suffolk County (617) 254-3800
SHANNON BYRNE PT, DPT
Physical Therapist
30 WARREN ST
BRIGHTON, MA 02135
Suffolk County (617) 254-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Wallace's NPI number?

The NPI number for Kevin Wallace is 1225388457. It was assigned to this individual provider in the NPPES registry on September 14, 2012.

Where is Kevin Wallace located?

Kevin Wallace practices at 30 Warren St, Boston, MA 02135. The listed phone number is (617) 254-3800.

What is Kevin Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Kevin Wallace was last updated on September 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.